Mechanisms of phosphorus and calcium homeostatic disorders in the development of cardiovascular events in patients with chronic renal diseases. The role of fibroblast growth factor 23 and Klotho


Cite item

Full Text

Abstract

The paper deals with the analysis of studies of the role of the bone morphogenetic proteins fibroblast growth factor 23 (FGF-23) and Klothno in the development of vascular wall calcification in chronic renal disease (CRD). FGF-23 is shown to be an important phosphaturic hormone that inhibits hypercalcemic and hyperphosphatemic effects of elevated serum vitamin D concentrations. There is evidence that there is an association between high serum FGF-23 levels and vascular wall calcification irrespective of the content of phosphorus and parathyroid hormone. Most authors regard FGF-23 as a potential uremic toxin in patients with end-stage CRD. There are data that support the renoprotective value of the morphogenetic protein Klotho whose expression in CRD is decreased.

About the authors

L Yu Milovanova

I. M. Sechenov Moscow Medical Academy

Email: Lussya2000@mail.ru
I. M. Sechenov Moscow Medical Academy

L V Kozlovskaya

I. M. Sechenov Moscow Medical Academy

I. M. Sechenov Moscow Medical Academy

Yu S Milovanov

I. M. Sechenov Moscow Medical Academy

Email: yumil2010@rambler.ru
I. M. Sechenov Moscow Medical Academy

I N Bobkova

I. M. Sechenov Moscow Medical Academy

Email: irbo.mma@mail.ru
I. M. Sechenov Moscow Medical Academy

I A Dobrosmyslov

I. M. Sechenov Moscow Medical Academy

I. M. Sechenov Moscow Medical Academy

References

  1. Zhang Qiu-Li, Rothenbacher D. Prevalence of chronic kidney disease in population-based studies: Systematic review. BMC Publ. Hlth 2008; 8: 117.
  2. Coresh J., Selvin E., Stevens L. A. et al. Prevalence of chronic kidney disease in the United States. J. A. M. A. 2007; 298: 2038-2047.
  3. Hruska K. A., Mathew S., Lund R. et al. Author manuscript; available in PMC 2009. Hyperphosphatemia of chronic kidney disease. Kidney Int. 2008; 74 (2): 148-157.
  4. Foley R. N., Parfrey P. S., Sarnak M. J. Clinical epidemiology of cardiovascular disease in chronic renal disease. Am. J. Kidney Dis. 1998; 32: S112-S119.
  5. London G. M. Cardiovascular risk in end-stage renal disease: vascular aspects. Nephrol. Dial. Transplant. 2000; 15 (suppl. 5): 97-104.
  6. Go A. S., Chertow G. M., Fan D. et al. Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. N. Engl. J. Med. 2004; 351: 1296-1305.
  7. Sarnak M. J., Levey A. S., Schoolwerth A. C. et al. Kidney disease as a risk factor for development of cardiovascular disease: A statement from the American Heart Association Councils on Kidney in Cardiovascular Disease, High Blood Pressure Research, Clinical Cardiology, and Epidemiology and Prevention. Hypertension 2003; 42: 1050-1065.
  8. Wright J., Hutchison A. Cardiovascular disease in patients with chronic kidney disease. Vasc. Hlth Risk Manag. 2009; 5: 713- 722.
  9. Locatelli F., Marcelli D. et al. Cardiovascular disease in chronic renal failure: the challenge continues. Nephrol. Dial. Transplant. 2000; 15 (suppl. 5): 69-80.
  10. Parfey P. S. Cardiac disease in dialysis patients: diagnosis, burden of disease, prognosis, risk factors and management. Nephrol. Dial. Transplant. 2001; 15 (suppl. 5): 58-68.
  11. Levin A. Clinical epidemiology of cardiovascular disease in chronic kidney disease prior to dialysis. Semin. Dial. 2003; 16 (2): 101-105.
  12. Gutiérrez O. M. Fibroblast growth factor 23 and left ventricular hypertrophy in chronic kidney disease. Circulation 2009; 119: 2545-2552.
  13. Block G. A., Hulbert-Shearon T. E., Levin N. W. et al. Association of serum phosphorus and calcium X phosphate product with mortality risk in chronic hemodialysis patients: a national study. Am. J. Kidney Dis. 1998; 31: 607-617.
  14. Kestenbaum B., Sampson J. N., Rudser K. D. et al. Serum phosphate levels and mortality risk among people with chronic kidney disease. J. Am. Soc. Nephrol. 2005; 16: 520-528.
  15. Westerberg P. A. et al. Regulation FGF-23 in CKD. Nephrol. Dial. Transplant. 2007; 22 (11): 3202-3207.
  16. Nakanishi S. et al. Serum FGF-23 levels predict the future refractory hyperparathyroidism in dialysis patients. Kidney Int. 2005; 68 (1): 410-411.
  17. Yean G. et al. High levels of serum FGF-23 are associated with increased mortality in long haemodialysis patients. Nephrol. Dial. Transplant. 2009; 24 (9): 2792-2796.
  18. Gutiérrez O. M., Mannstadt M., Isakova T. et al. Fibroblast growth factor 23 and mortality among patients undergoing hemodialysis. N. Engl. J. Med. 2008; 359: 584-592.
  19. Makoto K. Klotho in chronic kidney disease. What's new? Nephrol. Dial. Transplant. 2009; 24 (6): 1705-1708.
  20. Ramon I. et al. FGF-23 and its role in phosphate homeostasis. Eur. J. Endocrinol. 2010; 162(1): 1-10.
  21. Shigematsu T. et al. Possible involvement of circulating FGF-23 in the development of secondary hyperparathyroidism associated with renal insufficiency. Am. J. Kidney Dis. 2004; 44 (2): 250-256.
  22. Razzaque M. S. Does FGF-23 toxicity influence the outcome of chronic kidney disease? Nephrol. Dial. Transplant. 2009; 24 (1): 4-7.
  23. Marchais S. J., Metivier F., Guerin A. P. et al. Association of hyperphosphataemia with haemodynamic disturbances in end-stage renal disease. Nephrol. Dial. Transplant. 1999; 14: 2178-2183.
  24. Craver L., Marco M. P., Martinez I. et al. Mineral metabolism parameters throughout chronic kidney disease stages 1-5 - achievement of K/DOQI target ranges. Nephrol. Dial. Transplant. 2007; 22: 1171-1176.
  25. Davies M. R., Lund R. J., Mathew S. et al. Low turnover osteodystrophy and vascular calcification are amenable to skeletal anabolism in an animal model of chronic kidney disease and the metabolic syndrome. J. Am. Soc. Nephrol. 2005; 16: 917-928.
  26. Jono S., McKee M. D., Murry C. E. Phosphate regulation of vascular smooth muscle cell calcification. Circ. Res. 2000; 87: 10-17.
  27. Guillaume J. Peripheral vascular calcification in long-haemodialysis patients: associated factors and survival consequences. Nephrol. Dial. Transplant. 2009; 24 (3): 948-955.
  28. Raggi P., Boulay A., Chasan-Taber S. et al. Cardiac calcification in adult hemodialysis patients. A link between end-stage renal disease and cardiovascular disease? J. Am. Coll. Cardiol. 2002; 39: 695-701.
  29. London G. M., Guerin A. P., Marchais S. J. et al. Arterial media calcification in end-stage renal diseases: impact on all-cause and cardiovascular mortality. Nephrol. Dial. Transplant. 2003; 18: 1731-1740.
  30. Isakova T., Gutierrez O. et al. Postprandial mineral metabolism and secondary hyperparathyroidism in early CKD. J. Am. Soc. Nephrol. 2008; 19 (3): 615-623.

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

Copyright (c) 2010 Consilium Medicum

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
 

Address of the Editorial Office:

  • Alabyan Street, 13/1, Moscow, 127055, Russian Federation

Correspondence address:

  • Alabyan Street, 13/1, Moscow, 127055, Russian Federation

Managing Editor:

  • Tel.: +7 (926) 905-41-26
  • E-mail: e.gorbacheva@ter-arkhiv.ru

 

 © 2018-2021 "Consilium Medicum" Publishing house


This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies